Healthcare provider search based on experience

ABSTRACT

The embodiments of the present application relate to providing a distributed network-based system that allows users to search for potential healthcare providers that satisfy certain criteria and to dynamically identify healthcare providers that best meet a user&#39;s particular needs as defined by each specific search. In embodiments, the system creates experience score for each particular provider who matches the search criteria. The experience score is dynamically determined based on the type of search that is performed (e.g., search by specialty or search by condition or procedure), the query terms used in the search, and other factors including for example, the medical specialty/specialties the provider practices relative to the search performed, evidence the provider treats a condition and/or performs a procedure that matches the consumer&#39;s search, patient volume for the searched condition or procedure, total volume of patients, board certification(s) relevant to searched performed, disciplinary action information, malpractice claims history, and degree level attained by the healthcare provider. In other embodiments, the system dynamically ranks healthcare providers within a search results list from best choice to worst choice based on several factors including, for example, the type of search, the query terms used in the search, the quantity of providers who match the query, the locations of the providers who match the query, and the quality and other characteristics of providers who match the search query.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional PatentApplication No. 61/973,777 filed on Apr. 1, 2014, entitled “HEALTHCAREPROVIDER SEARCH BASED ON EXPERIENCE” which is incorporated herein byreference it its entirety.

BACKGROUND

Individuals generally try to learn as much information as possible aboutparticular healthcare providers, such as physicians, before selecting aprovider for healthcare services. The Internet has become a good sourceof information for patients to learn about potential healthcareproviders. However, one well-recognized problem with the Internet isthat the consumer often cannot determine the veracity of the informationwhich is revealed through a search. Further, since the information abouthealthcare providers on the Internet is often provided by the healthcareproviders themselves, this information may not be updated on a regularbasis and/or may contain inaccurate or incomplete information. Evenfurther, there is so much information about so many healthcare providersavailable on the web, it is often difficult, if not impossible, forindividuals to sort through the vast amount of information to identifythe best healthcare provider to meet his or her needs, particularlybecause the determination of which providers are best and the ranking ofhealthcare providers from best to worst depends on a variety of factorsthat may or may not be relevant to any particular search.

It is with respect to these and other general considerations thatembodiments disclosed herein have been made. Also, although relativelyspecific problems may be discussed, it should be understood that theembodiments should not be limited to solving the specific problemsidentified in the background or elsewhere in this disclosure.

SUMMARY

In general, the embodiments of the present application relate toproviding a distributed network-based business that allows users tolocate potential healthcare providers that satisfy certain criteria andto dynamically identify healthcare providers that best meet a user'sparticular needs as defined by each specific search. In embodiments, auser (e.g., a potential patient, an existing patient or some otherindividual) may access a webpage or website that provides the useraccess to a database of healthcare provider information. The websiteprovides the user with the ability to search for a healthcare providerbased on various items, including, but not limited to, informationassociated with actual experiences of the healthcare provider. Inembodiments, this actual experience relates to information gleaned fromactual insurance claims. These claims relate to claims for reimbursementby healthcare providers that detail the actual service(s) performed ongiven dates for specific patients and are described/coded by standardtaxonomy. Such actual claim information provides another level ofveracity to statements made by the healthcare providers themselves. Theactual experience information may also include self-reported informationgathered from the healthcare providers themselves about theirspecialties, conditions they have treated, and procedures they haveperformed. Additionally, actual experience information may includetraining information about a healthcare provider's education andtraining as it relates to their specialties, conditions they havetreated, and procedures they have performed.

The company maintaining the website (hereinafter, “the company”)compiles the criteria and provides a results list of healthcareproviders satisfying such criteria. For example, a company website whichprovides such information and services is www.HealthGrades.com, providedby HealthGrades, Inc. From this results list, a client may access aprovider profile using the information in the database.

In essence, the profile contains at least two sections. First, there isa section pertaining to the personal information of the healthcareprovider. This section permits healthcare providers to input the desiredbreadth and depth of the personal information about themselves. Thispersonal information may include age, gender, medical school, graduationdate, internships, fellowships, publications, current standing,languages spoken, medical philosophy, hobbies, etc. In otherembodiments, another party, such as HealthGrades, may input informationin this section as well. For instance, another party would most likelyadd board certification information and disciplinary action informationor links to such actions if any existed. The second section pertains tothe expertise and is based on the provider's actual experience. Thissection provides information relating to the provider's area(s) ofspecialty, education, training, the conditions treated by the provider,and the procedures performed by the provider. The information relatingto actual procedures performed and conditions treated comes from thehealthcare provider and/or from insurance companies. The informationfrom the insurance companies includes claim information related toactual claims made for healthcare services rendered. In someembodiments, the procedures performed and conditions treated arecompiled from sources including indications from a healthcare providerand indications from claims information. As such, a single condition orprocedure identified in a search potentially has multiple levels ofveracity applied to it: (1) Has the provider indicated they haveexperience with the condition or procedure (Yes/No)? (2) Does the claimsinformation further substantiate the healthcare provider has experiencewith the condition or procedure (Yes/No)? (3) To what degree (percentilecomparison of volumes against other providers in terms of patientvolumes for the condition or procedure) does the healthcare providerhave experience with the condition or procedure?

In embodiments, the expertise section includes an experience score foreach particular provider that is dynamically determined based on thetype of search that is performed (e.g., search by specialty or search bycondition or procedure), the query terms used in the search, and otherfactors including for example, the medical specialty/specialties theprovider practices relative to the search performed, evidence theprovider treats a condition and/or performs a procedure that matches theconsumer's search, patient volume for the searched condition orprocedure, total volume of patients the provider has seen over a certainperiod of time, whether the provider has board certification(s) relevantto searched performed, disciplinary action information including boardactions, sanctions, and malpractice claims history, and degree levelattained by the healthcare provider.

In embodiments, searches for providers by a user may be performed fromwithin the website of the company, while other embodiments involve theuse search engines external to the website (e.g., Google, Bing, Yahoo,etc.). Some embodiments relate to searches for human healthcareproviders, while others relate to searches for hospitals or other typesof treatment facilities. While some embodiments relate to searchesperformed on servers separate from insurance company servers, otherembodiments may include searching on such insurance company websites andservers.

As discussed herein, an aspect of a particular embodiment relates to adatabase of healthcare provider-related information, wherefrom data isgathered and compiled into the form of a profile and is made availableto users. Such profiles contain different types of verified informationfor each healthcare provider within the database. In an exemplaryembodiment, in response to a search query for a particular healthcareprovider name conducted using a search engine external to the companywebsite, the user receives a web-based “profile” of a selectedhealthcare provider matching, or closely matching, the entered searchterms. A profile lists detailed information potentially available aboutthat healthcare provider which may be obtained in the form of a profileor other displayable content. One embodiment of the invention providesfor a standard profile, which provides the healthcare provider'sspecialty and general location information (city/state) and provides ahyperlink for the user to get more information on that healthcareprovider. The other information may be verified in some manner, such asby the company or by some other independent third party. Such verifiedinformation may comprise board certifications, disciplinary action(s),if any, education information, years since medical school, etc. In anembodiment, the profile may also include a patient-provided informationsection, including patient experience surveys completed by patients ofthe healthcare provider and a place where users accessing the profilemay share their experiences with the healthcare provider.

An aspect of a particular embodiment relates to the different levels ofverified information available in each provider's profile, in which suchinformation may include: (1) a provider-verified section includinginformation from the provider that he or she feels will help a userchoose the provider; (2) a third party-verified section includinginformation received from third parties, such as board certifications,medical school, internship, residency, fellowship, licensureinformation, disciplinary action(s), if any, malpractice claims, if any,etc.; and (3) a patient-provided information section, including patientexperience survey responses by patients of the healthcare providerrelating their past experiences with the healthcare provider and/or withthe healthcare provider's practice.

In other embodiments, the distributed network-based system and websiteof the present application relates generally to how this verifiedhealthcare provider information may be accessed by users using thesearch capabilities provided by the company's webpage. In oneembodiment, a user receives a profile of a healthcare provider followinga search query by name for a particular healthcare provider. In otherembodiments, such as those involving search criteria limited to ahealthcare provider with a particular medical specialty, or experiencewith treating a condition or performing a procedure, a user will bepresented with a list of healthcare provider names with hyperlinks tothose healthcare provider's individual profiles. The providers areranked within the search results according to how well they match thesearch terms used in the search query.

In still other embodiments, the system described in the presentapplication dynamically ranks healthcare providers within a results listfrom best choice to worst choice based on several factors including, forexample, the type of search (e.g., search by specialty or search bycondition or procedure) run, the query terms used in the search, thequantity of providers who match the query, the locations of theproviders who match the query, and the quality and other characteristicsof providers who match the search query. More specifically, the systemcalculates a total boost score for each provider who matches the searchterms and uses the total boost score to rank providers within theresults list. The total boost score determines the relevancy ofhealthcare provider listings by applying multiple factors based on theconsumer's search criteria (e.g., medical specialty, search radius,etc.) and information detected about the providers who match thiscriteria. The total boost score is based upon factors including, forexample: distance between the healthcare provider office and theselected location; degree level attained by the healthcare provider;malpractice claims filed; the presence of malpractice judgments ormedical board sanctions; sanctions levied or other board actions againstthe healthcare provider; patient experience satisfaction score andsurvey volumes; healthcare provider board certification status; volumeof patients that provider has diagnosed/treated in relation to thecondition or procedure as indicated through claims volumes; volume ofclaims related to the conditions treated or procedures performed by thehealthcare provider; the volume of conditions or procedures with whichthe healthcare provider has verified having experience; conditions andprocedures the healthcare provider has verified they have experience intreating and performing and what healthcare providers are trained totreat and perform based upon their medical specializations; therelationship between searched conditions or procedures and claimsinvolving related conditions or procedures; the provider's total patientvolume for their practice in comparison to other provider practiceswithin the same medical specialty; and the quality of the provider'saffiliated hospitals as they relate to the search performed.

The various embodiments of the present application may be implemented asa computer process, a computing system or as an article of manufacture,such as a computer program product or computer-readable media. Thecomputer program product may be a computer storage media that isreadable by a computer system and is encoding a computer program ofinstructions for executing a computer process.

These and various other features, as well as advantages, whichcharacterize the present invention, will be apparent from a reading ofthe following detailed description and a review of the associateddrawings. This summary is provided to introduce a selection of conceptsin a simplified form that are further described below in the DetailedDescription. This Summary is not intended to identify key or essentialfeatures of the claimed subject matter, nor is it intended to be used inany way as to limit the scope of the claimed subject matter.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a logical representation of a network environment inwhich users are provided access to the company database containingprovider information, wherein the provider information includesclaims-related data from an aggregating source, in accordance with anembodiment of the present application.

FIG. 2 illustrates a search page on the company website, in accordancewith an embodiment of the present application.

FIG. 3A illustrates search results for a physician “by procedure” searchusing the network environment of FIG. 1 and the search page of FIG. 2,in accordance with an embodiment of the present application.

FIG. 3B illustrates the experience score detail page that is accessedfrom the experience score link 315 from FIG. 3A or FIG. 5.

FIG. 4 illustrates search results of a particular physician selectedfrom the search results of FIG. 3, in accordance with an embodiment ofthe present application.

FIG. 5 illustrates detailed information that may be included in aphysician expertise profile, which may be obtained after selecting toview the expertise information in the physician results depicted in FIG.4, in accordance with an embodiment of the present application.

FIG. 6 is a flow diagram illustrating operational characteristics of asearch resulting in the search results of FIG. 3, in accordance with anembodiment of the present application.

FIG. 7 is a flow diagram illustrating operational characteristics of asearch resulting in the search results of FIG. 4, in accordance with anembodiment of the present application.

FIG. 8 is a flow diagram illustrating the process 800 for using boostscores to rank search results for a DCP search, in accordance with anembodiment of the present application.

FIG. 9 is a screenshot illustrating search results for a search by “bycondition” search using the experience score from FIG. 3B and the totalboost score from FIG. 8, in accordance with an embodiment of the presentapplication.

FIG. 10 is a diagram illustrating a relationship between changing thedistance radius applied to a specialty search and a distance boothalgorithm.

FIG. 11 is a diagram illustrating a relationship between changing thedistance radius applied to a DCP search and a distance booth algorithm

DETAILED DESCRIPTION

The disclosure will now describe in detail exemplary embodiments withreference to the accompanying figure, in which the exemplary embodimentsare shown. Other aspects may, however, be embodied in many differentforms and the inclusion of specific embodiments in this disclosureshould not be construed as limiting such aspects to the embodiments setforth herein. Rather, the embodiments depicted in the drawings areincluded to provide a disclosure that is thorough and complete and whichfully conveys the intended scope to those skilled in the art. Whenreferring to the figures, like structures and elements shown throughoutare indicated with like reference numerals. Objects depicted in thefigures that are covered by another object, as well as the referenceannotations thereto, are shown using dashed lines. Optional steps ormodules are also shown using dashed lines.

FIG. 1 illustrates a logical representation of a network environment 100in which users are provided access to a database containing healthcareprovider information. As used herein, the term “healthcare provider”(also referred to simply as “provider”) shall mean a human being whoprovides healthcare services including without limitation doctors,dentists, therapists, physician assistants, nurse practitioners, nurses,chiropractors, and the like. Healthcare providers may make claims oninsurance companies for payment or partial payment for conditionstreated and/or procedures performed. A “user” is any person using thesystem 100, typically one seeking healthcare provider information. Assuch, other terms used to indicate such a user include “consumer,”“potential patient,” “past patient,” “current patient,” “referringphysician” and/or “patient.” In an embodiment, the network environment100 includes a patient computer 102, a communications network 104, alocal area network 106, a database 108 containing healthcare providerinformation 112, and a web server 110. While only one web server 110 isshown, more than one server computer or separate servers, e.g., a serverfarm, may be used in accordance with an embodiment of the presentinvention. Further, although only one patient computer 102 is shown,multiple patient computers could communicate with web server 110.Patient computer 102 may be a desktop computer, a laptop computer, amobile phone device, a tablet device, or any other devices that mayaccess the network 104 that gives access to websites or applications. Inembodiments, the Web server 110, database 108, and healthcare providerinformation 112 are maintained by the company, although not necessarilyso. The network environment 100 is not limited to any particularimplementation and instead embodies any computing environment upon whichfunctionality of the environment may be practiced.

The system 100 further involves a backend computer system 118, alsoreferred to as a data collection server 118. The data collection server118 maintains a database 402 that stores claims data 114. Claims data114 is the data related to insurance claims submitted for payment orreimbursement from insurance companies by healthcare providers, asdiscussed in more detail below. In some embodiments, claims data 114 maybe used as a measure of patient volumes for conditions and procedures(i.e., measures are not in terms of the number of claims submitted, butthe number of patients those claims represent). Also, in otherembodiments, healthcare providers may report their own patient volumesfor conditions and procedures, in which case claims data 114 would notbe the only source for condition and procedure information. Inaccordance with an embodiment of the present application, a potentialpatient may simply access the company's webpage 202, which provides theability to search and retrieve healthcare provider information 112 fromthe company's database 108, as shown in FIG. 1 to begin a search for ahealthcare provider. In such an embodiment, patient computer 102accesses web server 110 over communications network 104 and receives thewebpage 202 of FIG. 2. The exemplary webpage 202 displays search prompts204, 206 and 208 for a user to research doctors, dentists and/orhospitals, respectively. Although the term “hospitals” is used withrespect to exemplary webpage 202, other terms that may be used includeclinics, urgent care facilities, dialysis clinics, group practicesand/or other treatment facilities. In other embodiments, features of thepresent application can be implemented in native applications on mobiledevices. For instance, application designed for IOS or Android devicesmay be created to implement the features described and claimed in thepresent application.

To research a provider according to one embodiment of the presentapplication, a user may select search prompt 204 and use textbox 210 tosearch the provider by name, area of specialty, conditions treated,procedures performed, or textbox 212 to search by city/state. As usedherein, a search by conditions treated or procedures performed will bereferred to as a “DCP search.” After making the appropriate selection toresearch a provider, the user may click on “Search” icon 214 to beginthe search. In other embodiments, a user may browse into a searchlisting based upon an index of specialties, procedures and conditions.In such embodiments, no search form is required to gain access to searchlistings.

In another embodiment, a user may research a dentist by selecting searchprompt 206, and using textbox 210 to search the dentist by name, area ofspecialty, conditions treated, procedures performed, or textbox 212 tosearch by city/state. After making the appropriate selection to researcha dentist, the user may click on Search icon 214 to begin the search. Inyet another embodiment, the user may research hospitals by selectingsearch prompt 208, and using textbox 210 to search a search for freehospital ratings or a hospital profile. To begin the search, the usermay click on Search icon 214.

In accessing webpage 202 of FIG. 2, patient computer 102 accesses theweb server 110 and receives the webpage 202 from the company across acommunications network 104. The communications network 104 may be anytype of network conventionally known to those skilled in the art. Inaccordance with an exemplary embodiment, the network may be the globalnetwork, e.g., the Internet or World Wide Web. It may also be a localarea network or a wide area network. While the network may be any typeof network conventionally known to those skilled in the art, the networkis described in accordance with an exemplary embodiment as the “WorldWide Web.” As such, communications over the network occur according toone or more standard packet-based formats, e.g., HTTP, HTTPS, H.323, IP,Ethernet, and/or ATM.

In exemplary embodiments of webpage 202, a user typing within textbox210 or 212 invokes an autosuggest function. The autosuggest functionorganizes and displays search terms according to a probabilistic searchalgorithm. For example, if a user enters “knee” into textbox 210 toresearch physicians, various “knee”-related results are suggested. Theseresults include “Knee Surgery” in the ‘Healthcare Specialty’ category,“Knee Arthroscopy” in the ‘Procedures They Perform’ category; “KneeSprain” in the ‘Conditions They Treat ’ category; the physician “ErinKneedler , PT, Denver, Colo.” in the ‘Healthcare Providers NearLocation’ category; and “Knee Foot Ankle Center, Denver, Colo.” in the‘Group Practice near Location’ category. The user may then highlight orselect the desired search term from the autosuggest list. Inembodiments, when a user highlights a search term, content associatedwith the search term may be available for display. For example,highlighting “Knee Arthroscopy” from the above results produces a “Whatis a Knee Arthroscopy” section that informs the users of the kneearthroscopy procedure. On the other hand, highlighting “Erin Kneedler,PT, Denver, Colo.” from the above results produces a brief physicianprofile section on Erin Kneedler, including links to the results webpageof FIG. 4.

In some embodiments, a location of the user is always part of the searchprocess. For instance, if no search location or search location isprovided, one is determined based on last known information about theuser or some previous search request. That search location is used incombination with other search criteria to filter the providers thatsatisfy the search. For example, there may be a default distance radiusapplied to filter out providers who are located outside of the maximumradius from the search location. Default distance radius values may beset to: 1 mile, 5 miles, 10 miles, 25 miles, 50 miles, 100 miles, 200miles, 300 miles, 400 miles, 500 miles, 1000 miles, and National. Thesystem dynamically sets the default distance radius value based ondifferent factors including: the specialty, procedure or condition beingsearched; the rarity of the item being searched; the average fill ratesof providers who meet the searched criteria; a corresponding settingapplied to the searched term that defines the maximum distance radiusthat can be applied to the search; and a corresponding setting appliedto the searched term that defines the number of providers used todetermine the minimum radius from the searched location in which thatnumber of providers who match the searched term must be reached beforethe radius is selected.

In other embodiments, the radius may be automatically varied based on aninitial search result. For instance, in an exemplary embodiment a searchmay be performed on “Cardiology” in Denver, Colo. Cardiology is set, inthis example, to have maximum default distance radius of 100 miles fromthe searched location and is set to initially locate the first 200cardiologists closest to the searched the location to identify theminimum radius that may be applied as the default radius to the search.If 200 providers are found within 25 miles of the searched location, thedefault distance radius is set to 25 miles. If 200 providers are foundwithin 1 mile of the searched location, the default distance radius isset to 1 mile. If the 200 providers are found with 300 miles of thesearched location, the default distance radius is set to 100 miles perthe maximum default distance radius cap applied to the Cardiology searchterm. In embodiments, the default distance radius may be expanded orcontracted for specific search terms based upon the rarity of thecategory item being searched and the average fill rates of providersmeeting the searched criteria.

Options may be provided to allow the user to broaden their search bylocation information. For instance, a search may be conducted with adefault 100 mile radius from the location given. The user may increasethat radius to 250 miles to increase the number of providers thatsatisfy the search criteria. Alternatively, the user may narrow thesearch by decreasing the radius to 50 miles, for example.

Turning now to a detailed illustration of the search results obtainedafter researching a physician as shown and discussed in reference toFIG. 1 and FIG. 2, results for a DCP search by condition treated andgeographic location, sometimes referred to as “area code” is shown inFIG. 3. Similar results pages are generated for searches by area ofspecialty or procedures performed. In an embodiment, a physician searchby condition treated and geographic location may produce a results page302 with a results list 302 of physicians satisfying the search criteria(e.g., condition treated, state, city, and specialty) specified by theuser using a best-match ranking algorithm. In other embodiments, theproviders are ranked within the results list 302 based on a total boostscore, as discussed in more detail below.

In the exemplary embodiment depicted in FIG. 3A, each of the providerslisted in results list 302 performs the same procedure (e.g. kneereplacements), as illustrated in individual provider sections 306, 308,and 310, respectively and in summary label 312. Where the user requestsa search by area of specialty, each of the providers listed in theresults list 302 preferably has the same specialty. Where the userrequests a search by condition treated, each of the providers listed inthe results list 302 preferably treats the condition specified in thesearch query. Each of provider sections 306, 308, and 310 of the resultslist 302 include the provider names 314, 316, and 318, each of which isa hyperlink to a result webpage for that particular provider (shown inFIG. 4) or to a report 370 (e.g. profile) on that particular provider(shown in FIG. 5). Provider sections 306, 308, and 310 also includepatient satisfaction sections 322, 324, and 326, experience scores 322,324, and 326, and hospital quality sections 321, 323, and 325.

Patient satisfaction sections 322, 324, and 326 preferably include anaverage patient rating and a number of patients who have responded to apatient satisfaction survey.

Experience scores 315, 317, and 319 provide information about how muchexperience each particular provider 314, 316, and 318 has with respectto the specialty, condition, or procedure that was searched. Inembodiments, experience scores are dynamically determined for eachprovider each time a search is run and are based on the type of searchthat is performed (e.g., search by specialty or search by condition orprocedure) and the query terms that are used. As discussed generallyabove, experience scores are calculated based on a number of experienceattributes, each of which has points associated with it. Not all of theattributes are relevant to every particular provider for everyparticular search. The experience score is calculated by aggregatingpoint values associated with the relevant experience attributes for eachsearch.

FIG. 3B is a detail page or tab 402 about a particular provider'sexperience score for a particular search and is accessed by clicking theexperience score 315 from the results list 302 in FIG. 3A. In otherembodiments, detail page 402 may also be included as part of theprovider report 370 shown in FIG. 4. Detail page 402 lists one or moreof the experience attributes that may be used to determine theexperience score 315 for a particular provider (Dr. Jack Eng in thiscase) shown in provider section 306 of FIG. 3A. These experienceattributes include: medical specialization 410, conditions treated orprocedures performed 412, patient volume of searched DCP (conditiontreated or procedure performed) 414, total patient volume 416, boardcertification 418, board actions history 420, sanctions history 422,malpractice history 424, and degree obtained 426. The points for eachrelevant attribute are aggregated to form the experience scores 315,317, and 319. In an embodiment, each attribute has a maximum possiblepoint value and the experience score is derived from a fractionalcomparison of total points available for the aggregation of attributepoints for the relevant attributes vs. actual points achieved by eachprovider for these same attributes. In an embodiment, the total pointsavailable for an experience score for a provider is 100. In otherembodiments, certain attributes may be weighted more heavily than otherswithin the aggregation of all attribute points.

The following is a breakdown of each experience attribute and how it maybe applied and aggregated to form a total experience score.

The medical specialization attribute 410 considers what medicalspecialty/specialties the provider practices as compared to thespecialty that was searched. Providers who have specialties that matchthe specialty searched will receive more points for attribute 410 thanproviders who do not. In an embodiment, if the provider's medicalspecialty is an exact match to the specialty incorporated into thesearch (e.g., search is performed on or faceted by orthopedic kneesurgery and the provider has stated that they are an orthopedic kneesurgeon), the provider will receive the full points possible forattribute 410. If the provider's medical specialty is associated with,but is not an exact match to the medical specialty incorporated into thesearch (e.g., search is performed on or faceted by orthopedic kneesurgery and the provider has not stated that they are an orthopedic kneesurgeon, but they have stated that they are an orthopedic surgeon), theprovider will not receive any points for this attribute.

The conditions treated/procedures performed attribute 412 considersevidence, if any, that the provider has treated a condition and/orperformed a procedure that matches the consumer's search. In anembodiment, the points awarded for this attribute are based on whetherthe provider has verified the searched DCP and the claims volumesverification status for the searched DCP. For example, there may be sixdifferent levels of points a provider may receive for attribute 412 asshown in the table below, where 5x is the maximum amount of pointsavailable for this attribute:

Provider Points for Verification Status Attribute for Searched DCPClaims Volumes Verification Status for Searched DCP 412 Provider hasverified Claims volumes have verified the searched DCP and 5x thesearched DCP volumes are high enough to provide volume comparisonmetrics for the provider Provider has verified Claims volumes haveverified the searched DCP but 4x the searched DCP volumes are not highenough to provide volume comparison metrics for the provider Providerhas verified There are no claims volumes for the searched DCP 3x thesearched DCP Provider has not Claims volumes have verified the searchedDCP and 2x verified the searched volumes are high enough to providevolume DCP comparison metrics for the provider Provider has not Claimsvolumes have verified the searched DCP but  x verified the searchedvolumes are not high enough to provide volume DCP comparison metrics forthe provider Provider has not There are no claims volumes for thesearched DCP 0 verified the searched DCP

The patient volume of searched DCP attribute 414 awards points based onthe total volume of patients a particular provider has diagnosed,treated, or performed procedures on over a certain period of time (e.g.,over the past 12 months) for the particular condition or procedure thatis being searched. Like attribute 412, attribute 414 may be based uponmedical claims data or may be directly sourced from the provider ortheir representative. In some embodiments, the higher the patient volumea provider has for the searched condition or procedure, the more pointsthe provider will receive for attribute 414. In another embodiment, if aprovider meets a threshold patient volume for conditions diagnosed orprocedures performed, he or she gets the maximum points available forattribute 414 and if the provider patient volume is below the threshold,that provider does not receive any points for attribute 414.

The total patient volume attribute 416 awards points based on the totalvolume of patients a provider has seen over certain period of time, forexample the past 12 months. In an embodiment, points are awarded toproviders based on a fractional comparison of his or her total patientvolume compared with the patient volumes all provider total patientvolumes on record with the company. For example, if a provider haspatient volumes are higher than a certain number of standard deviationsof all provider total patient volumes on record in the database 116 atthe time of the search, that provider will receive the maximum pointspossible for attribute 416. If a provider has patient volumes that fallcomparatively within a certain number of standard deviations of allprovider total patient volumes on record at the time of the search, theprovider receives some points, but less than the maximum possible pointsfor this attribute 416. In one embodiment, this provider would receivepoints that are scaled in accordance with where their total patientvolumes fall within the comparative distribution curve of total volumesdiscussed above. If the provider has patient volumes below a certainnumber of standard deviations of all provider total patient volumes onrecord, the provider would not receive any points for attribute 416.

The board certification attribute 418 provides points for providers whohave any type of board certification. If the provider does not have anyboard certifications stored within the database 112 (FIG. 1), theprovider does not receive any points for this attribute.

The board actions history attribute 420 provides points for providerswho are free of board actions at the time of the search. Providers withboard actions do not receive any points for this attribute.

The sanctions history attribute 422 provides points for providers whoare free of sanctions at the time of the search. If the provider doesnot have any sanctions, the provider will receive the full pointspossible for this attribute. If the provider does have sanctions storedin the database 112 (FIG. 1), the provider does not receive any pointsfor this attribute.

The malpractice history attribute 424 provides points for providers whohave not had any malpractice claims filed against them at the time ofthe search. If so, they get full points for this attribute. If theprovider does have one or more malpractice claims, the provider does notreceive points for this attribute.

The education, degree obtained attribute 426 awards points based on thelevel of education this provider has obtained within their healthcarefield of study. In an embodiment, providers with a doctorate leveldegree (e.g., MD, DO, PhD, etc.) receive the maximum amount of pointsfor attribute 426. Providers with a mid-level degree (e.g. PA) receivesome points, but less than the maximum amount of points for thisattribute 426. If the provider does not have any medical degrees, theprovider does not receive any points for this attribute.

In embodiments, experience scores are dynamically determined for eachprovider each time a search is run and are based on the type of searchthat is performed (e.g., search by specialty or search by condition orprocedure) and the query terms that are used in each search. So forexample, the same particular provider might have one experience scorefor a search for providers who specialize in orthopedic surgery, adifferent experience score for search for providers who perform kneereplacements, a different experience score for a search for providerswho perform steroid injunctions, and still a different experience scorefor a search for providers who treat carpel tunnel syndrome.

Experience scores are also dynamically determined each time a search isrun based on the claims data 114 information that is currently stored inthe claims database 116 and the healthcare provider data 112 in database108 (all shown in FIG. 1). Information within these databases isconstantly being updated as providers provide additional information,the company receives additional claims data from insurance companies(e.g. regarding patient volumes, etc.), and third party information isupdated. So for example, the same particular provider might havedifferent experience scores for the same search performed at differenttimes is his or her claims volume data has increased or decreased, forexample.

Turning back to FIG. 3A, the hospital quality sections 321, 323, and 325summarize quality ratings and/or scores for hospitals with which thehealthcare provider is affiliated. In embodiments, the hospital qualitysections may comprise various ratings associated with the provider'saffiliated hospital, such as a hospital rating icon, an award icon, aservice line icon, and a cohort level icon. In other exemplaryembodiments, these rating icons may be located on the result webpageproduced by selecting the hyperlinked provider name, such as providernames 314, 316 and 318. In yet other exemplary embodiments, the ratingicons may be located on a separate webpage produced by selecting a linkon result page 302, such as hyperlinks within sections 321, 323, and325.

A hospital rating icon may indicate attributes of one or more hospitalsassociated with the provider. For example, hospital attributes mayinclude information, such as facility's name, address, Top 50 ranking(if available), clinical quality, readmission rates, timeliness of care,patient experience, etc. In certain embodiments, the hospital rating mayonly reflect ratings associated with one of the hospitals associatedwith a particular provider. The determination as to which hospital toassociate with the provider may include analyzing the percentage and ortotal of conditions treated or procedures performed, the relevancy ofthe search term to those percentages and/or totals, the location of thehospital, and/or other information pertinent hospital information.Hospital rating information is helpful to users because there are oftensignificant variations in health outcomes between hospitals within thesame community.

An awards icon may indicate awards received by the hospital, such asawards for, patient satisfaction, and key performance measures, such asrisk-adjusted mortality, complications and patient safety indices;30-day mortality and readmission rates; severity-adjusted average lengthof stay, etc.

A service line icon may indicate information associated with aparticular specialty group or wing of a hospital. For example, theservice line for a search for “Orthopedic Surgery” may refer to theorthopedic wing/department of the particular hospital associated withthe provider. In such an example, the service line icon may containorthopedic -specific information for the hospital, such as the number ofmusculoskeletal symptoms and complaints reported, patient satisfaction,average length of stay, readmission statistics, etc.

A cohort level icon may indicate information associated with theparticular condition or procedure identified in the search term(s). Forexample, a search for the condition “Total Knee Replacement” may produceprocedure-specific information for patients treated in the particularhospital associated with the provider. Such information may include, thepercentage and/or total number of patients treated who have had TotalKnee Replacements performed, patient satisfaction, mortality andcomplication rates, treatment cost estimates, etc.

In an embodiment where the results are too numerous to list on onewebpage, a hyperlink 320 to additional providers satisfying the searchresults, is included. In other embodiments, most if not all theproviders satisfying the search results are provided on the same resultspage. If the user is unable to see some of the providers' information onthe page, the user need only scroll down to view the rest. Such layoutsof lists are known to those skilled in the art. In an embodiment, forexample, multiple pages of results are returned for a single search. Insuch a case, the number of healthcare providers displayed per page maybe limited to a predefined number, such as 20. Additional controls areprovided to allow the user to navigate to other pages of results in sucha case. Pages are just a way of breaking up the returned listings intoconsumable views of 20 healthcare providers at a time for the performedsearch.

In another embodiment, e.g., where a hospital pays a fee to the company,a hyperlink to the hospital affiliated with a particular providerlisted, such as hyperlinks 322, 324, and 326, will also be providedunder that provider's name. In yet another embodiment, an advertisement328 for a practice group or hospital or other paying entity may beprovided at the top of the results page. This advertisement may be for apractice group or hospital closely related to the search criteria, or,in another embodiment, the advertisement may be for any entity orprovider. In an embodiment, the advertisement may contain a hyperlink330 for providing a report or ratings on that entity.

A user who selects to view a particular provider receives a resultswebpage 340 containing an overview of information about that particularprovider, as depicted in FIG. 4. In an exemplary embodiment, resultspage 340 contains multiple sections. The provider verified informationsection 342 contains provider personal information that has beenprovided by the provider, such as specialty information, gender, age,medical philosophy, years in practice, etc. This information may beprovided by the provider and may or may not be verified by anindependent third party.

The results webpage 340 may further include an expertise section 344.Expertise section 344 comprises information preferably verified by (e.g.gathered from) an independent third party, such as the company,regarding the provider's actual experience and training, such as boardcertification(s), licensure(s), and any and/or all malpractice suits anddisciplinary actions, both state and federal, to date or within acertain time period. In one embodiment, such verification may beexpressly noted in the profile. In essence, the verification of thisinformation provides a user with some assurance that the qualificationsof the provider have been checked by someone. In addition toverifications of board certifications and disciplinary actions, anembodiment may include verifications which also relate to the provider'smedical school(s), internship, residency, fellowship information, etc.In embodiments, the verification information may also includeperformance information, such as specialty, number of proceduresperformed, number of conditions treated, important dates, etc. In yetanother embodiment, as discussed below in reference to FIG. 5, the usermay click on a hyperlink 352 in this section to access a providerexpertise profile as shown in FIGS. 3B and 5.

Exemplary webpage 340 further includes a hospital quality section 346that comprises information concerning the medical facility (e.g.hospital) with which the provider is affiliated or associated. In oneembodiment, this section includes the facility's name, address, rating,awards, sanctions, pertinent facts concerning the facility's quality,and a hyperlink 354 to additional facility information (e.g., thewebsite of the affiliated facility or a Frequently Asked Questionswebpage). Such information provides the user with an understanding ofthe types of medical affiliations the provider has accrued and thelocales in which any procedures or treatments may occur.

Exemplary webpage 340 further includes a section 348 that comprisesinformation that relates to patient-provided information and,preferably, relates to information that has been provided by past orcurrent patients of the particular healthcare provider. In oneembodiment, patient ratings by current or former patients of theparticular provider may be available. This may further include nationalaverages based on certain predetermined questions conducted throughsurveys. By providing this information, the potential patient can viewpast performance of a particular doctor through another past or currentpatient's eyes. In another embodiment related to this section, the useraccessing the profile may click on a button 356 to rate the provider ifhe or she is currently, or has previously been, a patient of thatprovider (or other healthcare provider). In yet other embodiments, usersmay rate healthcare providers independent of whether they are actualpast or current patients.

Exemplary webpage 340 further includes section 350 which comprisescontact information for the provider, which, by way of example only, mayinclude location information, phone numbers, hours of operation,affiliated hospitals, health plans or other insurance information, etc.Additionally, in some embodiments, a hyperlink 358 may be provided toallow the user to directly access an appointment module from the resultswebpage. The user may set an appointment directly from the appointmentmodule.

While specific sections are shown and discussed in reference to theresults webpage, it is conceivable that the results webpage couldcontain numerous additional sections (while other embodiments maycomprise fewer sections). Further, while this disclosure has listedspecific types of information and data available in the results webpagein accordance with an embodiment of the present application, otherembodiments of the present application may include other types ofinformation and/or data. Moreover, other embodiments may have adifferent ordering of the sections or different buttons in the sections.The exemplary embodiments depicted and discussed herein are not intendedto limit the scope of the present application.

Turning now to FIG. 5, a detailed illustration of physician expertisepage 370 obtained after selecting expertise information hyperlink 352 ofa researched physician as discussed in reference to FIG. 4, is shown.Although healthcare provider expertise page 370 is referred to as a pageherein, it is to be understood that healthcare provider expertise page370 could be a popup, a tab, a tool tip, etc. The information inphysician expertise page 370 may be provided by the physician or thehealthcare provider and may or may not be verified by an independentthird party. In an exemplary embodiment, physician expertise page 370contains six sections. The first section 372 contains physician personalinformation, such as, gender, age, medical philosophy, years inpractice, contact information, etc. In embodiments, this section mayalso contain the experience score information discussed in connectionwith FIG. 3B and may also contain an appointment module 384 as describedabove.

The second section 374 comprises an enumerated list of the physician'sspecialty areas. In embodiments, a physician may elect to report ordisplay less than all of the physician's specialty areas. Thedetermination to under-report specialty area may allow the physician tosolicit patients in preferred specialty areas, while maintaining ordecreasing the number of patients in less preferred specialty areas. Insome embodiments, this may also contain the experience score 315 and theother information shown in FIG. 3B. In other embodiments, statisticsrelating to the volume of procedures and/or conditions performed in eachenumerated specialty area are displayed. Such statistical data providesusers with the ability to evaluate which potential physicians may bebest suited for the user's specific needs and treatments.

The third section 376 comprises an enumerated list of the proceduresactually performed by the physician. In embodiments, a physician may ormay not elect to report or display less than all of the performedprocedures. In other embodiments, the physician may not have controlover the information reported in this section. Statistics relating tothe volume of each procedures performed may be displayed with varyingdegrees of granularity, as discussed below. Similarly, the fourthsection 378 comprises an enumerated list of the conditions treated bythe physician. In embodiments, a physician may or may not elect toreport or display less than all of the conditions treated. Statisticsrelating to the volume of each conditions treated may be displayed withvarying degrees of granularity.

The fifth section 380 comprises information relating to the educationand training of the physician, such as medical school, residency andfellowship, among others. In embodiments, this section may also containa hyperlink 388 to the explanatory details of the information listed inthis section.

The sixth section 382 comprises information relating to the backgroundcheck of the physician. This information may include medical malpracticeproceedings, state and federal sanctions, board action, etc. Inembodiments, this section may also contain a hyperlink 390 to theexplanatory details of the information listed in this section.

In some embodiments, the physician expertise page 370 may also provide alink to other physicians 392 that links to physicians that also satisfythe search criteria. Or, alternatively, link 392 simply links to aresults list of similar physicians.

While six sections are shown and discussed in reference to physicianexpertise page 370, it is conceivable that physician expertise page 370could contain numerous additional sections. Further, while thisdisclosure has listed specific types of information and data availablein the physician expertise page in accordance with an embodiment of thepresent application, other embodiments of the present application mayinclude other providers, types of information and/or data. Moreover,other embodiments may have a different ordering of the sections ordifferent buttons in the sections. The exemplary embodiments depictedand discussed herein are not intended to limit the scope of the presentapplication.

Returning to FIG. 1, the data 112 may be acquired by the server 108 fromdata collection server 118 and may be verified and/or validated by athird party. Claims data 114, also referred to as provider expertiseinformation may include: area(s) of specialty, the total number ofpatients treated for a condition by a particular healthcare provider,the total number of patients treated for a procedure by the healthcareprovider, the volume of patients for a specific condition as apercentage of all conditions treated, the total volume of patientswithin a provider's practice, and the volume of procedures (on a patientlevel) as a percentage of all procedures performed. In one embodiment,the company web server 110 may have access to a means to aggregateexpertise information about the provider. Such means may include aprogram, method, routine, etc., such as aggregation routine (not shown),that, when executed by web server 110, causes web server 110 toestablish a network connection over communications network 104 to a datacollection server 118 containing current provider expertise information114. In another embodiment, data collection server 118 may establish thenetwork connection to web server 110 based upon a predefined timeinterval or an on demand request by a user to generate a healthcareprovider profile. In such embodiments, the network connection to datacollection server 118 may be authenticated by data collection server118, prior to aggregating requested provider expertise information 114.After aggregating requested provider expertise information 114, the datacollection server 118 may transmit to the web server 110 any providerexpertise information 114 that has been altered and/or updated since webserver 110 last connected to data collection server 118.

In another embodiment, the company may make requests to a third partyfor provider expertise information 114. The requests may be made inresponse to analysis by the company regarding provider specialtycategories; the frequency distribution of diseases diagnosed/treated,conditions diagnosed/treated, or procedures recommended/performed; or acombination thereof. In such embodiments, the third party may aggregate,and provide to the company, medical claims data regarding in-patient andout-patient procedures, treatments, and/or conditions. In embodiments,the third party supplying the provider expertise information 114 mayobtain the medical claims data from institutions providing clearing andsettlement services, provider practice management information systems,vendors, and/or hospitals.

When the company receives the provider expertise information 114, theprovider expertise information 114 is inserted into, or used to update,the associated records in database 108. In embodiments, receivedprovider expertise information 114 is associated with healthcareprovider information and data 112 in database 108 through provideridentifiers, such as a National Provider Identifier (NPI). The providerexpertise information 114 received by the company may be categorized andaggregated into buckets of data (e.g., groups of ICD-9 codes). In oneembodiment, company web server 110 contains the functionality to receiveand import the provider expertise information 114 into database 108. Inanother embodiment, data collection server 118 or another third partynot shown provide a file or similar database 116 containing the providerexpertise information 114 that may be processed by one or morecomponents in network environment 100 of FIG. 1 before being entered into the company database. As the technologies and processes involved inimporting data into a database are well-known to those in the art, anyfurther explanation as to the accessing databases of the architecturesurrounding the implementation of databases is omitted.

In an embodiment where the results are too numerous to list on onewebpage, a hyperlink 420 to additional providers satisfying the searchresults, may be included, as discussed with respect to FIG. 3. In otherembodiments, most if not all the providers satisfying the search resultsare provided on the same results page. In another embodiment, e.g.,where a hospital pays a fee to the company, a hyperlink to the hospitalaffiliated with a particular provider listed, such as hyperlinks 422,424, and 426, will also be provided under that provider's name. In yetanother embodiment, an advertisement 328 for a practice group orhospital or other paying entity may be provided at the top of theresults page.

With respect to FIG. 6, a process 500 for researching healthcareprovider information, as in FIG. 3, is shown in accordance with anembodiment of the present application. Start operation 502 is initiatedfollowing user access of company web server 110 over a communicationsnetwork 104 and the transmittal of webpage 202 to patient computer 102.From start operation 502, the operation flow of the process proceeds tothe query operation 504. Query operation 504 determines whether the userwould like to research physicians 506, dentists 508, or hospitals 510.Although the process includes two potential healthcare providers, i.e.,physicians and dentists, other healthcare providers could be searchedfor, and information provided. If the user selects to researchphysicians 506, flow branches to the physician query operation 512,wherein the physician query operation 512 determines whether the userwould like to search for physicians by name 514, specialty 516,conditions treated 518, procedures performed 520 or city/state 522. Inan embodiment, location only is a search performed where a user has notspecified a specialty, condition, procedure, or provider/group practicename. When a location only search is performed, all providers arereturned for the specified location regardless of medicalspecialization. Otherwise, location may be used as part of any othersearch to filter the various results to those nearest the determinedlocation.

If the user selects to research dentists 508, flow branches to dentistsquery operation 524, wherein the dentists query operation 524 determineswhether the user would like to research dentists by name 526, specialty528, conditions treated 530, procedures performed 532 or city/state 534.If the user selects to research hospitals 510, flow branches to thehospital query operation 536, wherein the hospital query operation 536determines whether the user would like to research hospitals byevaluating ratings 538 of hospitals meeting specified criteria, or byreceiving a hospital profile 540. In accordance with other embodimentsof the present application, the company web server 110 may provideadditional search scenarios and types of healthcare entities for whichto search. Examples of such entities may include dialysis centers andgroup practices.

With respect to FIG. 7, a process 550 for researching healthcareprovider information, as in FIG. 4, is shown in accordance with anembodiment of the present application. Start operation 552 is initiatedfollowing user receipt of the search results from a search performed oncompany webpage 202. From start operation 552, a user may either selecta healthcare provider 556 or may first view additional results 554, ifany are available. Upon selecting a healthcare provider 556, the userwill receive additional results related to the selected physician, suchas information on the physician's background, the quality of thefacilities associated with the physician, patient feedback, andappointments and offices. If the user selects to research thephysician's background, flow branches to background query operation 558,wherein background query operation 558 determines whether the user wouldlike to research the physician's specialties 559 (e.g., specialty areas,conditions treated, procedure performed, experience score, etc.),certifications 560, sanctions 561, malpractice complaints 562, boardactions 563, education and training 564, awards and recognitions 565,languages spoken 566, or procedure/condition 567. If the user selects toresearch the quality of the facilities associated with the physician,flow branches to the facility query operation 570, wherein the facilityquery operation 570 determines whether the user would like to researchthe facility's location 571, ratings 572, awards 573, or additionalfacts 574 relating to the quality of the facility. If the user selectsto research the feedback from patients on their experience with thephysician, flow branches to the feedback query operation 578, whereinthe feedback query operation 578 determines whether the user would liketo research various patient survey results 579 or facts relating topatient satisfaction surveys 580. If the user selects to research thephysician's appointments and offices, flow branches to the offices queryoperation 584, wherein the offices query operation 584 determineswhether the user would like to research the insurances accepted by thephysician 585, locations of the physician's offices 586, appointmenttimes 587, or to access an appointment module 588.

In particular embodiments, the system dynamically ranks the healthcareproviders returned as a result of a provider search from best providersto worst providers, where the best providers are listed first.Determining which providers are best depends on the type of search run(e.g., DCP search vs. a specialty search), the query terms used, thequality and other characteristics of the providers who meet the searchquery. More specifically, the providers are rank ordered within sortedsearch results in accordance with a total boost score based on variousmeasures. The total boost score is a summation of values for boosts(i.e., boost scores) available for the type of search performed in whichthe provider is listed.

There are various types of boosts, each of which may or may not have avalue (positive, negative, or zero) associated with it for anyparticular provider. The boost values are used to calculate the totalboost score for a particular healthcare provider The types of boostsinclude: a certification boost, a degree boost, a distance boost, alegal boost, a PES (“Patient Experience Satisfaction Score and SurveyVolumes”) boost, Experience boost, one or more parent boosts, a hospitalquality boost, and a practicing specialty term boost.

FIG. 8 is a flowchart illustrating the process 800 for using boostscores to rank search results for a DCP search, such as a search forproviders who treat Male Breast Cancer (condition) near Tampa Fla.

Process 800 starts by at step 802 when a search is initiated. Step 804identifies the specialty, condition, or procedure specified in thesearch query. This specialty, condition, or procedure will be used todetermine the boost score value for one or more of the boosts discussedbelow. At step 806, the system identifies all of the healthcareproviders that meet the query for the search. A total boost score willbe identified for each of these providers.

At step 810, the system determines the certification boost for eachprovider, which boosts the search results rank of a provider if he orshe has one or more board certifications. For example, a provider whohas at least one board certification may receive a certification boostwith a positive value. Providers who do not have a board certificationwill have a certification boost value of 0. In an embodiment, providerswho have multiple board certifications will have a higher certificationboost value than providers who have only one board certification. Inanother embodiment, providers who have a board certification from aboard associated with the American Board of Medical Specialties (“ABMS”)will have a higher certification boost than providers who have acertification from another board.

At step 812, the system determines the degree boost for each provider,which provides for increasing the search results rank of a provider ifhe or she has doctorate level degree. In one embodiment, providers withdoctorate level degree get a higher degree boost value than providerswith a mid-level degree (e.g. PA degree). Providers who do not have anyof these degrees will have a degree boost value of 0. In otherembodiments, a provider with a PA degree will receive the same degreeboost value as providers with other types of degrees.

At step 814, the system determines the legal boost for each provider,which provides for lowering the search results rank of providers whohave received malpractice claims, disciplinary actions, or othersanctions. In an embodiment, a provider who has one or more malpracticeclaims in the past 5 years will have a negative value for the legalboost, as will providers who have any sanctions or any board actions.Providers with no malpractice claims, disciplinary actions, sanctions orboard actions will have a legal boost value of 0. In an embodiment, thetypes of legal boost values are cumulative, so for example, a providerwho has a malpractice claim and a sanction would have a total legalboost a larger negative value than a provider who has only a malpracticeclaim, for example.

At step 816, the system determines the PES (Patient Experience Survey)boost for each provider, which provides for raising the search resultsrank of providers based on the number of patient experience surveyresponses they have received and/or the average patient satisfactionrating they have received from patient experience survey responses. Inanother embodiment, the provider may receive a PES boost if the numberof survey responses exceeds a threshold number and/or the average ratingfor this provider exceeds a threshold rating level.

At step 818, the system determines the experience boost for eachprovider, which provides for raising the search results rank ofproviders who have verified (e.g. self-reported) that they haveexperience in a treating a condition or performing a procedure and theclaims data associated with the provider also indicate experience intreating the same condition (or performing the procedure). Inembodiments, providers may receive a positive boost value if they haveself-reported that they have experience treating searched condition(e.g., male breast cancer) and the claims data confirms that they hasthis experience. In exemplary embodiments, the experience boost isincorporated into the total boost score based on whether the providerhas verified the searched DCP and the claims volumes verification statusfor the searched DCP. For example, in a user search query fordermabrasion, if 1) a provider has verified the dermabrasion procedureand 2) the claims volumes have verified dermabrasion and the volume ofclaims are high enough to provide volume comparison metrics for theprovider, an Experience boost may be calculated. Alternately, if 1) aprovider has not verified the dermabrasion procedure and 2) the claimsvolumes have verified dermabrasion but the volume of claims are not highenough to provide volume comparison metrics for the provider, a smallerexperience boost value may be applied or a value of zero may be applied.In such embodiments, a healthcare provider may also receive a boost fora determination that the reported claims volumes are credible.

In an embodiment, a provider will receive a different Experience boostvalue for each of the following scenarios:

Provider Verification Status for Searched DCP Claims VolumesVerification Status for Searched DCP Value Provider has verified ClaimsVolumes have Verified Searched DCP and 5x Searched DCP Volumes are HighEnough to Provide Volume Comparison Metrics for the Provider Providerhas verified Claims Volumes have Verified Searched DCP but 4x SearchedDCP Volumes are NOT High Enough to Provide Volume Comparison Metrics forthe Provider Provider has verified There are no Claims Volumes for theSearched DCP 3x Searched DCP Provider has NOT Claims Volumes haveVerified Searched DCP and 2x verified Searched Volumes are High Enoughto Provide Volume DCP Comparison Metrics for the Provider Provider hasNOT Claims Volumes have Verified Searched DCP but  x verified SearchedVolumes are NOT High Enough to Provide Volume DCP Comparison Metrics forthe Provider Provider has NOT There are no Claims Volumes for theSearched DCP 0 verified Searched DCP

At step 820, the system determines one or more Parent boosts for eachprovider, which provide for raising the search results rank of providerswhose expertise information has a parent/child relationship withpreviously-searched and/or previously-identified specialty, condition,and/or procedure information. In embodiments, if a searched specialty,condition, or procedure (i.e., “DCP”) is identified as a child toanother DCP for which there is provider verification (e.g., the providerhas self-reported this information) and/or claims volumes indicate theprovider has experience with the parent DCP, the provider will receive apositive value for a first parent boost. For example, in a user searchquery for laminectomy, if provider verification and/or claims volumesfor lamina procedures (the parent DCP for Laminectomy) are identified,the provider will receive a first parent boost value that is a positivenumber. The boost value, or some percentage thereof, is then applied tothe user's DCP search for child DCP Laminectomy. In another example, ifthe specialty searched is based on the condition “male breast cancer,”the first parent boost may relate to breast cancer generally (e.g., maleand female) and a second Parent boost may relate to cancer generally(e.g., all other cancers such as lung cancer, skin cancer, etc.). Theseadditional boosts aid in scoring the relevancy of results returned froman initial search on male breast cancer. In an embodiment, there can beup to five parent/child relationship generations for a searched DCP.Summing the total boosts for each parent/child relationship generate atotal composite Parent Boost value for the provider.

At step 822, the system determines the hospital quality boost, whichprovides for raising the search results rank of providers if they areadmitted to or have privileges with a hospital that meets a minimumquality threshold. In embodiments, the value of the hospital boost foreach physician may vary based on the ratings and information aboutaffiliated hospitals relative to what is searched. For example, if thesearch seeks providers who perform knee replacements, a provider who isaffiliated with a hospital that is rated very highly for kneereplacements (cohort level), or orthopedic surgery (service line level),and/or general (hospital level) may receive a higher positive boostvalue for the hospital boost than a provider who is not affiliated withsuch a highly rated hospital. In an embodiment, a provider might receivea negative boost value if he or she is affiliated with a hospital withpoor ratings.

At step 824, the system determines the distance boost for each provider,which provides for increasing the search results rank of providers basedon the distance between a provider's office location and the consumer'ssearch location factors. In some embodiments, the distance boost valuemay be varied based on the type of search performed. For example, in thecase of specialty searches (e.g., Cardiologists near 123 Main Street,Denver, Colo.), it is important to find a provider in the searchedspecialty that is closest to the searched location. If all providers arelocated within a reasonable distance, providers are then differentiatedfrom other providers based on attributes other than distance (e.g.,patient satisfaction score). As such, when the returned search resultsare narrowed to a local market using the distance radius applied to thesearch listings (e.g., to list providers within 1 mile, 5 miles, 10miles, etc.), the role of boosting distance in these cases is lesssignificant because all of the providers listed are already within aclose proximity, and the values that differentiate one provider from thenext in terms of quality of care become more significant (e.g., aconsumer is likely to drive an extra five miles to see a provider ifthat provider has a higher patient satisfaction score than a providerwho is close to their searched location).

As the distance radius applied to the search listing expands, however,(e.g., to 25 miles, 50 miles, 100 miles and above), the inverse of thisrelationship becomes a more likely (e.g., a consumer is less likely todrive 100 miles to a see a provider because that provider has excellentpatient satisfaction scores when there are providers closer who havegood patient satisfaction scores, but not as high as the provider who is100 miles away). To accomplish applying a distance boost value thatbalances the proximity of a provider to a searched location vs. theother attributes that differentiate those providers in terms of qualityof care, a sliding distance boost value algorithm is applied that takesinto account the distance radius applied to the search listing and itsrole in determining how the distance boost adjusts to either elevatedistance to ensure that local providers are favored over distantproviders or elevates differentiating attributes outside of distancebecause the providers displayed are already favored in terms of beingwithin a local market.

In particular embodiments, a physician specialty search may be performedfor physicians specializing in “Dermatology.” If no search location wasspecified, the location of the computing device may be determined, asdescribed above, and a default radius. In this example, however, theexpertise of the specializing physician may be significantly lessimportant to the user than the distance to the physician. As such, thestatistical weight/value assigned to the distance boost may be high,e.g., 0.7 on a scale of 0.0 to 1.0, compared to other scored values inthe search, e.g., certification boost value may be 0.05 and degree boostvalue may be 0.1, and the default radius may be smaller, e.g., 35 miles.In this example, 100 providers are found within 35 miles of the searchedlocation. Of the 100 providers, 10 providers are located within 5 milesof the searched location, 25 providers are located between 5 and 20miles of the searched location, and 70 providers are located between 20and 35 miles of the searched location. In certain embodiments, thoseproviders located within 5 miles of the searched location may receive arelatively high distance boost value, e.g., 0.5, while those providerslocated outside of the 5 mile search radius receive distance boostvalues that decrease inversely proportionate to the provider's distancefrom the searched location. For example, providers located between 5 and20 miles of the searched location may receive distance boost values of0.3, while providers located between 20 and 35 miles of the searchedlocation may receive distance boost values of 0.15.

In other embodiments, instead of receiving proportionately diminishinglocation values for providers located further away from the searchedlocation, the location value is determined by the size of the searchradius in relation to the distance of the provider from the searchedlocation. For example, a physician specialty search may be performed forphysicians specializing in “Dermatology” within 15 miles of Denver,Colo. In this example, 40 providers are found within 15 miles of thesearched location. Of the 40 providers, 5 providers are located within 5miles of the searched location, 15 providers are located between 5 and10 miles of the searched location, and 20 providers are located between10 and 15 miles of the searched location. Although the expertise of thespecializing physician may be significantly less important to the userthan the distance to the physician, a relatively small search radius hasbeen defined. As such, the statistical weight and/or boost assigned tothe location value may be only slightly elevated or even slightlydepressed compared to other scored values in the search. In certainembodiments, providers located within 5 miles of the searched locationmay receive a distance boost value of 0.15, providers located between 5and 10 miles of the searched location may receive a distance boost valueof 0.14 and providers located between 10 and 15 miles of the searchedlocation may receive a distance boost value of 0.13. In another example,the above physician specialty search for physicians specializing in“Dermatology” is extended from within 15 miles of Denver, Colo. towithin 100 miles of Denver, Colo. In this example, the same 40 providersare found within 15 miles of the searched location, 100 providers arelocated between 15 and 50 miles of the searched location, and 250providers are located between 50 and 100 miles of the searched location.This time, because a relatively large search radius has been defined,the statistical weight and/or boost assigned to the location value maybe significantly elevated compared to other scored values in the search.For instance, the 40 providers located within 15 miles of the searchedlocation (previously receiving distance boost between 0.13 and 0.15) mayreceive a distance boost value of 0.5, providers located between 15 and50 miles of the searched location may receive a distance boost value of0.25 and providers located between 50 and 100 miles of the searchedlocation may receive a distance boost value of 0.1. FIG. 10 is a diagramthat shows how changing the distance radius applied to a specialtysearch would affect the distance applied to two doctors within thelistings based upon this sliding distance booth algorithm.

In the case of condition or procedure (“DCP”) searches (e.g., providerswho perform Total Knee Replacements near 123 Main Street, Denver,Colo.), consumers want to find a provider who is most experienced intheir specific care needs and are more willing to travel the distance toseek the care they need should local providers not have that same levelof experience. In the case of DCP searches, a high Experience boost(discussed above) value is applied for a providers with experiencelevels in the searched DCP and the distance boost value that is appliedbecomes a secondary measure applied to refine ordering providers withinthe search results when providers have close to same experience scores.As the distance radius applied to the search increases, the role ofdistance as a boost diminishes on a sliding scale. Once the distanceradius applied to the search reaches 100 miles or highest, the distanceboost value is 0 and it is removed entirely from the total boost score.In this way, the system identifies the most experienced providers fortheir healthcare needs without having distance obscure those findings.

For instance, in an exemplary embodiment, a DCP search may be performedfor physicians performing the procedure “Brainstem Surgery.” In thisexample, because no search location was specified, the search processmay use a geographical IP location (“geo-IP”) service to identify thegeographical location of the computing device being used to perform thesearch request. The location of the computing device may then be used todetermine the centroid of a geographical area, e.g., city or zip code,to be used to perform the DCP search. A default radius may then bedefined, e.g., 500 miles. In such an example, the expertise of thephysician performing the procedure may be significantly more importantto the user than the distance to the physician. As such, the statisticalweight and/or boost assigned to the location value may be low, e.g., 0.1on a scale of 0.0 to 1.0, compared to other scored values in the search,e.g., certification boost value may be 0.25 and degree boost value maybe 0.4. In this example, 1,000 providers are found within 500 miles ofthe searched location. Of the 1,000 providers, 5 providers are locatedwithin 10 miles of the searched location, 100 providers are locatedbetween 10 and 50 miles of the searched location, and 895 providers arelocated between 50 and 500 miles of the searched location. In certainembodiments, those providers located within 10 miles of the searchedlocation may receive a relatively low distance boost value, e.g., 0.1,while those providers located outside of the 10 mile search radiusreceive distance boost values that decrease inversely proportionate tothe provider's distance from the searched location. In otherembodiments, instead of receiving proportionately diminishing distanceboost values, those providers located outside of the 10 mile searchradius may uniformly receive a nominal distance boost, e.g., 0.001, or adistance boost value of 0. FIG. 11 is a diagram that shows how changingthe distance radius applied to a DCP search would affect the distanceapplied to two doctors within the listings based upon this slidingdistance booth algorithm.

If and when values exist for these different boosts, adding themtogether provides a total boost score so that the provider can beranked, i.e., placed in the list of providers that also have some scorevalues. For example, if a provider has a degree boost value of +0.4 anda certification boost value of +0.25, then these two boost scores areadded together to give the provider a single total boost score value of+0.65 that is then used to rank order the provider against otherproviders within the search results. In all cases, a provider's totalboost score determines the provider's position within search resultrankings for the search performed. The higher the total boost score, thehigher the provider will be displayed within the search listings. Forexample, a provider with total boost score of 2.5 will be deemed morerelevant to the search performed and thus will be displayed higher inthe listings than provider who has a total boost score of 1.5.

For specialty searches, there may also be a Practicing Specialty termboost for each provider that provides for raising the search resultsrank of providers if their specialty is an exact match to the medicalspecialty incorporated into the search terms. For example, if a searchis performed on or faceted by orthopedic knee surgery and the providerhas stated that they are an Orthopedic Knee Surgeon, that provider willreceive a practicing specialty term boost value of greater than 0. Ifthe specialty searched is not an exact match, the practicing specialtyterm boost value is zero.

Returning now to FIG. 8, in step 826 the system determines a total boostscore for each provider based on an aggregation of one or more of theboosts described above. At step 828, the system determines whether atotal boost score has been determined for each provider who matches thesearch results. If it has not, the system proceeds to step 808. If atotal boost score has been determined for each provider who matches thesearch query, the system proceeds to step 830 where the providers areranked in the search results based on their total boost scores. In apreferred embodiment, providers are ranked by total boost score wherethe provider with the highest total boost score is ranked first and theprovider with the lowest total boost score is ranked last.

In embodiments, specific algorithms employed for each type of boostincorporated into the total boost score and combine various measuresrelevant to the type of boost and weights or values that govern theimportance of that boost as a portion of the total boost scoregenerated. For example, in a search by condition or procedure (DCP), theprovider's experience boost may be deemed to be more important inordering providers within the search results listings than the PES boostand is weighted accordingly within the overall total boost score.Weights applied within each boosting algorithm are flexible and subjectto change in order to refine and improve the relevancy of the calculatedboost scores.

In such embodiments, these boost algorithm factors are assigned weightsand/or scores. The application of weights and/or scores to these factorsallows certain results in the results list to be elevated or “boosted”over other results in results list 302 that may have not been boosted orthat may have been devalued by applying the boost algorithm. Forexample, in response to a search for physicians located in Denver, Colo.with an expertise in Knee Arthroscopy, a results list containing twophysicians may be produced. The first-ranked physician on the resultslist may receive the following boosts: Experience boost (e.g., KneeArthroscopy) +1.5, Degree boost (e.g., MD) +0.4, PES boost +2.5,Distance boost (e.g., User is within 5 miles of physician's office)+4.0. The second-ranked physician on the results list may receive thefollowing boosts: Experience boost (e.g., Knee Arthroscopy) +1.5, Degreeboost (e.g., MD) +0.4, PES boost +3.5, Distance boost (e.g., User iswithin 25 miles of physician's office) +2.0, Sanctions boost (e.g.,Physician has received a sanction(s), board action(s) or malpracticeclaim(s) in the last 5 years) −0.5. In this example, the first-rankedphysician receives a total boost score of 8.8, whereas the second-rankedphysician receives a total boost score of 6.9. The first-rankedphysician is, therefore, better than the second-ranked physician andthus is displayed higher within the results list than the second-rankedphysician. The process of boosting may result in a search results orderthat is sorted alternately to a search results order in which the boostalgorithm was not applied.

In more detailed embodiments, the boost algorithm discussed abovedetermines the relevancy of healthcare provider listings by applyingmultiple factors matched to a consumers search criteria (e.g., medicalspecialty, procedures the provider has experience performing, conditionsthe provider has experience treating, etc.). In exemplary embodiments,the combination of expertise information supplied by the healthcareprovider, expertise information supplied by a third party, and,optionally, comparison measures using claims volumes, is used to boosthealthcare providers within results list 302. In such embodiments, auser may further boost healthcare providers in results list 302 byfurther refining the expertise information in results list 302. In suchembodiments, the boost algorithm for each type of boost that isincorporated into the total boost score may combine various measuresthat are relevant to the type of boost and weights that govern theimportance of that boost as a portion of the total boost score. Forexample, in a search for physicians, the physician's Experience boostmay be deemed more important than the PES boost to physician rankingwithin the results list. Accordingly, the physician's Experience boostmay be more heavily weighted within the total boost score. Inembodiments, the weights applied within each boosting algorithm may beflexible, such that the weights may be changed without difficulty inorder to refine and improve the relevancy of the calculated boostscores.

In another example, users may be allowed to refine their search toincorporate multiple layers of experience information and then elevateor boost healthcare providers by experience even further within thelistings based upon those refinements. For example, searching onOrthopedic Surgeons in Denver, Colo. returns a relevant listing ofproviders who are identified as being Orthopedic Surgeons. Refining thatsearch to now include Orthopedic Surgeons who have experience performingKnee Replacements not only limits the listings of providers to matchingthat criteria, but then re-ranks those providers in accordance with theexperience level (for example, as a measure of patient volume determinedvia claims) in performing Knee Replacements. Refining that search evenfurther to include Orthopedic Surgeons who have experience performingKnee Replacement and who have experience with patients in the treatmentof Osteoarthritis, again limits listings and re-ranks providers basedupon experience.

In an exemplary embodiment, if the total boost score value exceeds apredetermined threshold, the display will include an indication that theprovider treats the searched condition. Other embodiments will showwhether particular providers perform specific procedures, e.g., theprocedure for which the user initially searched.

In other embodiments, information may be suppressed from, or devaluedin, a provider's profile when the boost algorithm is invoked. Forexample, a heart surgeon may have operated on a patient having other,non-related conditions, such as diabetes. Consequently, the patient willbe diagnosed as having a pulmonary condition and a diabetic condition.In such a case, the provider performing the heart surgery may beincorrectly reported as treating both condition categories (pulmonaryand diabetic). Therefore any statistical information gathered from theheart surgery that would contribute to associating the provider withtreating diabetic conditions may be suppressed or devalued. Such aprocess may serve to make the data in the provider profiles moreaccessible to users who may not have extensive medical knowledge or maynot be familiar with medical reporting procedures.

FIG. 9 is a results page 900 of a preferred embodiment of the presentinvention and illustrates a screenshot from a DCP search for providerswho treat male breast cancer and are located near Tampa, Fla. Banner 902summarizes the search query that was used for this search. The searchresults 900 may be sorted in different ways using the sort button insection 904. The “best match” option sorts the search results by thetotal boost score as described in connection with FIG. 8. FIG. 9 showsthe first page of the search results, additional pages may be viewed byselecting the page navigation hyperlink 906. The two highest rankedproviders are shown in FIG. 9. Each provider has his or her own section908 and 910 of the results list. Each provider section 908 and 910 mayinclude various types of information such as specialty information 912and 914, patient satisfaction information 916 and 918, an experiencescore 920 and 922, and hospital quality information 924 and 926, as wasdescribed in connection with FIG. 3A. It will be appreciated thatalthough the first healthcare provider (Dr. Sylvia Campbell) has a lowerexperience score (81) than the second healthcare provider (Dr. AtefZakhary) (83), Dr. Campbell is listed first because she has a highertotal boost score than Dr. Zakhary. While total boost scores may bebased in part on similar factors to experience scores, the total boostscore may also be based on factors that are not considered forexperience scores including, for example, distance and hospital quality.

Having described the embodiments of the present invention with referenceto the figures above, it should be appreciated that numerousmodifications may be made to the present invention that will readilysuggest themselves to those skilled in the art and which are encompassedin the spirit of the invention disclosed and as defined in the appendedclaims. Indeed, while presently preferred embodiments have beendescribed for purposes of this disclosure, various changes andmodifications may be made which are well within the scope of theembodiments presented herein. For example, the present embodiments maynot be limited specifically to healthcare provider information but,instead, may be applicable to any kind of professionals, such asengineers, accountants, veterinarians, dentists, etc. Additionally, theinclusion of specific operations and the order of operations shown inthe flow diagrams illustrated in FIGS. 6, 7 and 8 are provided forillustrative purposes only and, in accordance with other embodiments,steps may be removed, reordered, modified, or performed simultaneously.Furthermore, it should be appreciated that the scope of the presentembodiments accommodates other operations that may be added or removeddepending on the needs of the particular entity or entities implementingor using the system.

Similarly, although this disclosure has used language specific tostructural features, methodological acts, and computer-readable mediacontaining such acts, it is to be understood that the present inventiondefined in the appended claims is not necessarily limited to thespecific structure, acts, or media described herein. The specificstructure, acts, or media are disclosed as exemplary embodiments ofimplementing the claimed invention. The invention is defined by theappended claims.

What is claimed is:
 1. A system for identifying healthcare providers,the system comprising: a processing unit; and a memory coupled to theprocessing unit, the memory encoding computer executable instructionsthat, when executed by the processing unit, perform a method comprising:receiving a request to search for one or more of the healthcareproviders, wherein the request includes a search query; assigning atotal boost score to each of the one or more healthcare providers whomatch the search query, wherein the total boost score is based on one ormore values from a group comprising: a certification boost, a degreeboost, a distance boost, a legal boost, an experience boost, a parentboost, an affiliated hospital boost, and a practicing specialty termboost; ranking the one or more healthcare providers who match the searchquery based on the total boost score to create a ranked results list;and providing access to the ranked results list over a computer network.2. The system defined in claim 1, wherein the request to search for oneor more of the healthcare providers further comprises a type of searchfrom a group consisting of: name, specialty, location, diagnosis,conditions treated, and procedures performed.
 3. The system defined inclaim 2, wherein the total boost score assigned for each of the one ormore healthcare providers who match the search query is based in part onthe type of search.
 4. The system defined in claim 2, furthercomprising: determining a search location for the request to search forone or more of the healthcare providers; and defining a search radiusvalue from the search location based on the type of search.
 5. Thesystem defined in claim 4, wherein the total boost score for each of theone or more healthcare providers is based on a distance boost and thedistance boost for each of the one or more healthcare providers is basedon the type of search.
 6. The system defined in claim 4, wherein thetotal boost score for each of the one or more healthcare providers isbased on a distance boost and the distance boost is based on acomparison of a provider location of each of the one or more healthcareproviders who match the search query and the search radius value fromthe search location.
 7. The system defined in claim 1, wherein the totalboost score for each of the one or more healthcare providers is based onan experience boost and the experience boost is based on self-reportedinformation received from each of the one or more healthcare providerswho match the search query, wherein the self-reported informationcomprises one or more categories from a group comprising: procedurevolume information; and conditions treated information.
 8. The systemdefined in claim 7, wherein the experience boost is based claimsinformation received from one or more insurance companies regarding eachof the one or more healthcare providers who match the search query andthe claims information includes one or more categories from a groupcomprising: procedure volume information; and conditions treatedinformation.
 9. The system defined in claim 1, wherein the total boostscore is based on all of the following: a certification boost, a degreeboost, a distance boost, a legal boost, an experience boost, and anaffiliated hospital boost.
 10. A computer-implemented method ofproviding healthcare provider information to users, said methodcomprising: receiving, by a server comprising at least one computerprocessor and memory, a request to search for one or more of thehealthcare providers, wherein the request includes a search query with asearch term; creating an experience score for each of the one or morehealthcare providers who match the search query, wherein the experiencescore is based on the search query and one or more attributes from agroup comprising: a medical specialty, a condition treated, a procedureperformed, a patient volume for the search term, a total patient volume,a board certification, a board actions history, a sanctions history, amalpractice history, and a level of degree; creating a search resultslist using the experience score for each of the one or more healthcareproviders who match the search query; and providing access to the searchresults list over a computer network.
 11. The method as defined in claim10, wherein information regarding the condition treated attribute isreceived from the one or more healthcare providers who match the searchquery.
 12. The method as defined in claim 10, wherein informationregarding the condition treated attribute is received from one or moreinsurance companies.
 13. The method as defined in claim 12, wherein thecondition treated attribute relates to one or more conditions and isbased on claims data received from the one or more insurance companies,wherein the claims data comprises a total number of patients treated forthe one or more conditions by each of the one or more healthcareproviders.
 14. The method as defined in claim 10, wherein informationregarding the procedure volume attribute is received from one or moreinsurance companies.
 15. The method as defined in claim 14, whereininformation regarding the procedure volume attribute relates to one orprocedures and is based on claims data from the one or more insurancecompanies, wherein the claims data comprises a total number of patientswho received the one or more procedures performed by each of the one ormore healthcare providers.
 16. The method as defined in claim 15,further comprising aggregating information regarding the procedurevolume attribute from multiple insurance companies and using theaggregated procedure volume information to create the search resultslist.
 17. The method as defined in claim 10, wherein the search resultslist includes a hyperlink to a report on an affiliated hospital, medicalcenter, or other type of treatment center for each of the one or morehealthcare providers.
 18. The method as defined in claim 10, whereindisciplinary action attribute indicates that the healthcare provider hasnot received any disciplinary actions.
 19. The method as defined inclaim 10 further comprising: creating a healthcare provider profileusing the experience score for each of the one or more healthcareproviders who match the search query.
 20. The method as defined in claim10 wherein the search term comprises a procedure and the experiencescore is based the patient volume for the procedure.